Understanding osteopathic practice worldwide
Osteo-TAQ: providing critical insights into osteopaths’ approaches and decisions
The osteopathic profession faces increasing global integration and the need for evidence-informed, person-centered care. Osteopathy is often described by scope of practice, such as musculoskeletal, pediatrics or sports, or technique-based labels, e.g. cranial, visceral or structural. While common, these descriptors offer a superficial understanding of how osteopaths approach patient care.
Developed from qualitative grounded theory research, the Osteopaths’ Therapeutic Approaches Questionnaire (Osteo-TAQ) captures how osteopaths think, make decisions and interact with patients. It is the first tool of its kind to measure the multidimensional aspects of osteopathic care.
Located within the Centre for Osteopathic Research and Leadership (CORaL), this international research programme investigates how osteopaths understand and approach their clinical practice. It provides critical insights into the diverse ways osteopaths practice across different countries, education systems and healthcare settings.
Research goals
The Osteo-TAQ aims to investigate how osteopaths think about therapeutic approaches, clinical decision-making and professional identity across a range of healthcare, educational and cultural contexts. It will also examine the similarities and differences in osteopathic practice internationally and what these reveal about the profession’s values and diversity.
To achieve this, it will be necessary to translate, culturally adapt and validate the Osteo-TAQ for use in different countries and jurisdictions.
Future applications include the use of the tool with osteopathy students, to investigate how their understanding of practice evolves during clinical training. The validation of Osteo-TAQed is currently a PhD project at Health Sciences University (HSU) led by Chris Wilkes.
The project aims to integrate the Osteo-TAQ with other validated tools, (e.g. ABS-mp, PABS-PT, Jefferson Scale, CARE) and Patient-Reported Outcome Measures (PROMs), to explore links between practitioner beliefs and patient outcomes.
Finally, the development of Osteo-TAQ aims to support evidence-informed improvements in osteopathic education, policy and regulation by providing robust, comparable data across settings.
Team and collaborators
The project’s lead investigator is Dr Oliver Thomson of HSU, UK. Oliver is supported by a team of international collaborators:
- Dr Brett Vaughan – University of Melbourne, Australia
- Dr Chantal Morin – Université de Sherbrooke, Canada
- Dr Michael Fleischmann – Victoria University, Australia
- Dr Jerry Draper-Rodi – HSU, UK
- Dr Gopi Anne McLeod – University Technology Sydney, Australia
- Dr Elena Golder – Plymouth Marjon University, UK
- Erwann Jacquot – Centre International d’Ostéopathie CIDO, Saint-Etienne, France
- Dr Loïc Treffel – Institut Toulousain d’Ostéopathie, ITO-Pôle Recherche, Toulouse, France
- Prof Steven Vogel – HSU, UK
Key findings / progress
The development and content validation of the Osteo-TAQ was completed in 2022. This included an initial exploratory factor analysis, informed by a grounded theory study of osteopaths’ clinical reasoning and therapeutic decision-making. A follow-up content validity study, involving international experts, then refined and validated the questionnaire items and structure.
In 2024, an Australian national study confirmed the Osteo-TAQ’s factor structure and revealed four key domains of therapeutic approaches, while in 2025, a French national study demonstrated the tool’s cross-cultural relevance, highlighting shared and distinctive conceptions of practice.
The UK national study is currently underway, supported by The Osteopathic Foundation.
The Osteo-TAQed PhD project will be launched in autumn 2025 to investigate how students’ conceptions of practice evolve across their clinical training. This will be a mixed-methods longitudinal study.
The tool is now being translated and adapted for use in additional jurisdictions, with new international partners joining the research programme.
Funding and support
The Osteopathic Foundation has funded the £19,000 UK study, and the programme has also applied to the foundation for partial funding support for the HSU PhD studentship.
Osteopathy Australia has provided £10,000 of funding, with HSU providing support for the project.
Impact and applications
The Osteo-TAQ research programme has wide-ranging implications for osteopathic education, regulation, clinical practice and international policy. It offers a validated, adaptable tool that enhances understanding of clinical reasoning, practice and professional identity within osteopathy.
The programme will enhance education and training by supporting curriculum development. It will provide insights into how students’ therapeutic approaches evolve, helping educators design learning environments that foster safe, evidence-informed and person-centered care. The Osteo-TAQed will provide formative and summative evaluation metrics for student progression, professional identity development and clinical readiness.
Osteo-TAQ will help to inform regulation and professional standards, as it is developed from qualitative research – interviews and observations of osteopaths in practice. This means it offers insight into the real-world variation and consistency of osteopathic practice, enabling regulators to better align standards with realities of practice. These insights can also inform capability frameworks, CPD planning and revalidation by tracking changes in clinical reasoning and attitudes over time.
The enabling of global comparison and professional identity is a major application of the programme. Osteo-TAQ is building a cross-national evidence base that will foster mutual recognition and deeper global collaboration within the profession. It also highlights how therapeutic approaches are shaped by cultural, regulatory and educational contexts, supporting more inclusive and context-sensitive policies.
When used for clinical practice improvement and research integration, Osteo-TAQ can be used alongside other validated measures of beliefs, attitudes and behaviours, e.g. ABS-mp, PABS-PT and the Jefferson Scale, to offer a richer understanding of clinical reasoning. It can be integrated with PROMs to explore how practitioners’ conceptions of care relate to patient experiences, expectations and outcomes. This will help to bridge the gap between practitioner intentions and patient-perceived care, strengthening the evidence base for person-centered osteopathy.
Finally, the Osteo-TAQ programme is advancing research capacity and influence, by enabling international collaborative research across Europe, Australia and the UK. It will support the development of the next generation of osteopathy researchers, including PhD students and early career scholars. It will also build long-term capacity in educational research, psychometrics and cross-cultural comparative methodology, including supporting the HSU PGR community to become a leader in applied health sciences research.
Key Publications
- Thomson, O. P., Treffel, L., Wagner, A., Jacquot, E., Draper-Rodi, J., Morin, C., & Vaughan, B. (2025). A national survey of osteopaths’ conceptions of practice in France: structural validity of the Osteo-TAQfr and the tendency toward technical rationality. BMC health services research, 25(1), 451. https://doi.org/10.1186/s12913-025-12540-z
- Thomson, O.P., McLeod, G.A., Fleischmann, M. et al. Therapeutic approaches and conceptions of practice of osteopaths in Australia – a national cross-sectional study and exploratory factor analysis of the Osteo-TAQ. BMC Health Serv Res 24, 1332 (2024). https://doi.org/10.1186/s12913-024-11826-y
- Thomson, O. P., McLeod, G. A., Fleischmann, M., & Vaughan, B. (2024). Development and adaptation of the Osteopaths’ Therapeutic Approaches Questionnaire (Osteo-TAQ) for the Australian osteopathic profession-A cognitive interview study. International Journal of Osteopathic Medicine, 53, 100723. https://doi.org/10.1016/j.ijosm.2024.100723
- Thomson, O. P., Vaughan, B., Sampath, K., Draper-Rodi, J., Fleischmann, M., & Cerritelli, F. (2022). The osteopaths’ therapeutic approaches questionnaire (Osteo-TAQ) – A content validity study. International Journal of Osteopathic Medicine, 45, 48-54. https://doi.org/10.1016/j.ijosm.2022.07.001
- Thomson, O. P., & Anstiss, V. (2020). The development and exploratory analysis of the osteopaths’ therapeutic approaches questionnaire (Osteo-TAQ). International Journal of Osteopathic Medicine, 37, 17-24.https://doi.org/10.1016/j.ijosm.2020.07.002
- Thomson, O. P., Petty, N. J., & Moore, A. P. (2014). Clinical decision-making and therapeutic approaches in osteopathy – a qualitative grounded theory study. Manual therapy, 19(1), 44-51. https://doi.org/10.1016/j.math.2013.07.008
- Thomson, O. P., Petty, N. J., & Moore, A. P. (2014). A qualitative grounded theory study of the conceptions of clinical practice in osteopathy – a continuum from technical rationality to professional artistry. Manual therapy, 19(1), 37-43. https://doi.org/10.1016/j.math.2013.06.005
Get Involved
We welcome engagement from:
- Osteopaths willing to complete the Osteo-TAQ or participate in interviews
- Educational institutions interested in applying the tool in student settings
- Students and researchers looking to contribute to international osteopathy research
- Professional bodies exploring regulation, CPD or policy development
Researchers to explore how the Osteo-TAQ might be used in other cultural, clinical and international contexts
